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When I finished my fellowship in 2002, my fellowship director said, never advertise yourself as a lip surgeon, because you’ll have a disaster. What’s funny is that I basically become a lip surgeon, and I do a ton of lip corrective surgeries several times a week, and I don’t have the complication rate he had. Does that mean that he was a bad surgeon? No, he’s one of the best surgeons I’ve known. The reason why was the technology. So back in the late 90s early 2000s, what was really involve solid implants into the lips, specifically Gore-Tex soft form. Now, there’s silicone coated with Gore-Tex, and the funny thing is that year we had so many emergencies. We had to go back, fly in to take out an infected implant, implant that migrated, implant that shrunk. And in my first textbook Comprehensive Facial Rejuvenation, I wrote in 2002, I showed how these implants even they don’t get infected, become very firm, hard and shrink. So, you can feel these lumps inside the mouth. So first of all, if you do have one of these solid implants, you don’t like the way it feels, the way it looks, or you don’t see any benefit whatsoever. It’s actually pretty easy for me to take them out. I’ve taken a lot of these out under a simple Dental block where you don’t feel my block. Your lips are totally numb. You’re totally awake. You don’t feel anything. And I can slip that implant out pretty well. So, if you’ve got one of these Gore-Tex soft form implants that feel like a little rock inside your mouth, I can actually get rid of those for you pretty easily. So, that’s the first lesson. Second lesson is I don’t do them. And why don’t I do them? For all the reasons I’ve just enumerate, they shrink. they become hard, they lose shape. And the other real reason, besides just the mechanical issues that occur with solid implants, is that they just don’t look good. They don’t provide volume that you can’t shape it. What’s great for me when I do fat grafting for a permanent solution and fillers for a temporary. But oftentimes permanent long-lasting once you build it solution for lip augmentation is that the lips and also lip lifts, lip lifts of these are other ways in the right patient. But what’s beneficial by doing these surgeries? Sorry, by doing this volume is that I can shape it. Think of like a sculpture. I can actually shape it. So biggest issue on the top lip, when you put a solid implant is that it just looks like a line, and natural lips have areas that are larger, like in the midline where they start tapering and soften to 0 on the on the outer portion. Bottom lips have more fullness in the center, and they taper down. You simply can’t do that with a solid implant. It’s just a line. So, this podcast is about why not to do solid implants how to fix all of the implants. And just to tell you that, please consider either fat grafting or fillers. Now in the past, many years ago, you may say, Dr. Lam, you put fat grafting. The biggest evolution that has allowed me to do fat graft in the lips is really two things pure graft and micro fat. So, in the past, putting fat in the lips would cause lumpiness and a massive recovery time. What I’ve been doing in the last few years I’ve been using pure graft that allows me to process the fat to its purest form, so there’s a high viability, very little loss of the transplanted fat. In addition to that, I further break down the fat to a finer particle, so it’s much smoother in the way. It feels and looks in the lip and has much less recovery time. So, now I think fat graft in the lips is actually amazing, viable alternative to fillers, which 10 years ago, I would have said, that’s not the case.

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